Pulse Brain · Growing Health Evidence Index
Tier 2 — RCT / large cohortPeer-reviewed

Cost-Effectiveness of Mitral Valve Repair Versus Replacement for Severe Ischemic Mitral Regurgitation

Bart S. Ferket, Gorav Ailawadi, Annetine C. Gelijns, Michael A. Acker, Samuel F. Hohmann, Helena Chang, Denis Bouchard, David O. Meltzer, Robert E. Michler, Ellen Moquete, Pierre Voisine, John C. Mullen, Anuradha Lala, Michael J. Mack, A. Marc Gillinov, Vinod H. Thourani, Marissa A. Miller, James S. Gammie, Michael K. Parides, Emilia Bagiella, Robert L. Smith, Peter K. Smith, Judy Hung, Lopa Gupta, Eric A. Rose, Patrick T. O’Gara, Alan J. Moskowitz, for the Cardiothoracic Surgical Trials Network (CTSN) Investigators*, Wendy C. Taddei‐Peters, Dennis Buxton, Nancy L. Geller, David F. Gordon, Neal Jeffries, Albert Lee, Claudia S. Moy, Ilana Kogan Gombos, Jennifer Ralph, Richard D. Weisel, Timothy J. Gardner, Deborah D. Ascheim, Ellen Moquete, Helena Chang, Melissa Chase, James Foo, Lopa Gupta, Katherine Kirkwood, Edlira Dobrev, Ron Levitan, Karen O’Sullivan, Jessica Overbey, Milerva Santos, Deborah Williams, Paula Williams, Xia Ye, Michael J. Mack, Tracine Adame, Natalie Settele, Jenny Adams, William H. Ryan, Paul Grayburn, Frederick Y. Chen, Anju Nohria, Lawrence Cohn, Prem Shekar, Sary F. Aranki, Gregory Couper, Michael Davidson, R. Morton Bolman, Rita Lawrence, Eugene H. Blackstone, Carrie Geither, Leoma Berroteran, Diana Dolney, Kristen Doud, Suzanne Fleming, Roberta Palumbo, Christine Whitman, Kathy Sankovic, Denise Kosty Sweeney, Gregory Pattakos, Pamela A.G. Clarke, Michael Argenziano, Mathew Williams, Lyn Goldsmith, Craig R. Smith, Yoshifumi Naka, Allan Stewart, Allan Schwartz, Daniel Bell, Danielle Van Patten, Sowmyashree Sreekanth, John H. Alexander, Carmelo A. Milano, Donald D. Glower, Joseph P. Mathew, J. Kevin Harrison, Stacey Welsh, Mark F. Berry, Cyrus J. Parsa, Betty C. Tong

Circulation Cardiovascular Quality and Outcomes · 2018

Read source ↗ All evidence

Summary

This cost-effectiveness analysis, based on a randomised controlled trial of 251 patients with severe ischaemic mitral regurgitation, found minimal differences in costs and quality-adjusted life years between mitral valve repair and replacement over 2 years. Over longer time horizons (10 years), replacement showed a small uncertain cost-effectiveness advantage due to lower cardiovascular readmission rates, though survival benefit was minimal and cost differences remained statistically uncertain.

UK applicability

This analysis is based on US hospital cost data and healthcare system structures; direct applicability to UK practice would require adjustment for National Health Service cost structures, surgical capacity, and patient pathways, though the clinical trial outcomes and comparative effectiveness patterns may be informative.

Key measures

In-hospital costs, 2-year cumulative costs, quality-adjusted life years (QALYs), incremental cost-effectiveness ratios, cardiovascular readmission rates, survival

Outcomes reported

The study compared costs, quality-adjusted life years (QALYs), cardiovascular readmission rates, and survival outcomes between mitral valve repair and replacement strategies over 2, 5, and 10-year time horizons.

Theme
General food systems / other
Subject
Other / interdisciplinary
Study type
Research
Study design
Cost-effectiveness analysis based on RCT data with microsimulation for extrapolation
Source type
Peer-reviewed study
Status
Published
Geography
United States
System type
Human clinical
DOI
10.1161/circoutcomes.117.004466
Catalogue ID
BFmor3gavd-rcc9a0

Topic tags

Pulse AI · ask about this record

Dig deeper with Pulse AI.

Pulse AI has read the whole catalogue. Ask about this record, its theme, or how the findings apply to UK farming and policy — every answer cites the underlying studies.